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This book comprises four lectures delivered at the University of Indiana in 1958 by a distinguished member of the faculty of the National University of Mexico, who had come to Bloomington as Visiting Professor for the Patten Foundation. The thesis of his lectures is, briefly, the impact of the Columbian discoveries on the thought of contemporary Europe, as well as their impact on the discoverers themselves. "The Invention of America" is another way of saying the realization of the significance of the western land mass; of perceiving what it, in effect, was, and what its importance was with respect to the traditional continents. Columbus might sight land on that famous October 12, but there could be no "America" until the western land mass was identified as such. Professor O'Gorman's book traces the development of the continental concept. In pre-Columbian days, the traditional concept of the world derived from the Greek Oikoumene the world-island of Europe, Asia, and Africa, encompassed by the ocean-sea. Columbus himself was wedded to this theory, and sailed on his initial venture confident that he would reach the Orient. In fact, on both his First and Second Voyages he was convinced that he had reached Asia, and that Cuba was a peninsula of the mainland. But his Third Voyage gave rise to uncomfortable doubts, for the land mass of Venezuela extended far to the east, and the flood of water of the Orinoco showed that he had reached a terrain of continental dimensions. This must be separate from Asia—else how did Marco Polo sail from China to India? The only explanation was that a strait must separate mainland Asia from the new-found "Terrestrial Paradise." However, this explanation received a rude shock on the Fourth Voyage, when the coasting of Central America proved that no strait existed. Conveniently, therefore, the Admiral forgot all about Marco Polo, and ended his days with the belief that Venezuela was connected to Central America by a land bridge and hence was an actual part of Asia. Vespucci's ideas, by contrast, developed somewhat in the other direction. After his 1499 voyage, he felt that Venezuela-Brazil was an addition to the Malay peninsula, projecting far to the east of Asia itself, but his 1501 voyage convinced him that South America was a separate land mass because of its great size and southern extension. He felt, however, that North

circulating fluids, either directly from the vessels which circulate ?ed blood, or through some one of the emunctories which secrete and discharge superfluities; it is effected at another time, by the operation of means which solicit an equal distribution of blood and vital energy in the extreme parts; and which thus equalize the circulation of the mass, but which do not directly and evidently diminish its quantity. "'I shall endeavour, says Dr. J. to describe these different conditions with as much precision as I can, aware at the sametime that I shall be held to be tedious and irksome by many ; instructive and correct, perhaps, only by. a few.
" In proceeding to considei this part of the subject, I shall first notice the mode of management to be adopted in that form of fever which arises from a source of personal infection, and which is now usually distinguished by the name of typhus. It is, perhaps, the form of fever to which cold water may be applied with greater expectations of success than any other?without previous preparation of condition by means of art. It seems to arise from sources differently concentrated, or differently modified ; and, though I may not be cori*fect, 1 shall state what occurs to me on this head.
1. There exists a febrile indisposition, which seems to draw its origin from a cause which is generated in crowded and ill-ventilated apartments?among persons who are not generally confined to the sick-bed. This happens frequently in jails, in ill-constructed and crowded barracks. The disease, so produced, is usually of short duration, its period rarely exceeding five days. It then subsides ; but it often recurs again at a short interval. It is the lc/ast fixed of any of the forms of the infectious lever; and it yields more cerw tainly than any of the others to the affusion of cold water on the surface, particularly when the affusion is preceded by an emetic.. 2. A form of infectious fever, the cause of-which is apparently referred to emanations from diseased subjects, also presents itself frequently to observation. This form arises chiefly among those who attend upon sick in hospitals, or elsewhere. Its period i? longer than that of the preceding; for it rarely rcaches its termination betore the seventh day. It then sometimes only changes form, and it frequently passes through another septenary revolu-2 tion, *166 Dr. Jackson, 6n Cola J fusion in Fevet.
tion, feven sometimes two other septenary revolutions, befofe ?? terminates finally. The affusion of cold water on the surface is here ordinarily a powerful remedy in itself; but it is less sovereign than in the preceding; for, as the diseased action is Strong, the mode determined and steady, the remedy does not always make impression sufficiently forcible to arrest the course abruptly and effectively?without the aid of such previous preparation as moderates the violence of the rrtorbid action, or,-as simplifies complication where that exists. 3. Infectious fever likewise presents itself, as arising apparently from a cause lodged upon clothing and such other dead matters as have been in contact with the bodies of sick persons. The cause'may here be supposed to bo' condensed, or otherwise modified by the medium through which it is conveyed 5 for the effect produced actually appears with a different aspect from that of the two preceding. The movement of the morbid action is often slow and obscure ; but though obscure, it is not easily acted upon, so as to be dissevered by the impression of feeble powers. The course is tedious : changes generally occur at septenary periods, but the sum of the total duration frequently extends to several weeks j and in fact, the disease often assumes one or other of the forms in which the affusion of cold water on. the surface docs not produce abrupt and decisive effect, unless the circumstances have been changed previously by the preparation of the fit condition.?The conditions, which I have thus described, occur to me as connected with the particular form and concentra-* tiom of cause; but 1 am ready to confess, at the same time, that their real boundaries, may not. be found to be so precise in all cases as I have stated them to be. It is however true, and it must have been observed by others as well as myself, that the duration of the disease is short where the source is chiefly impure air, especially as produced by the undue accumulation of persons in ill-ventilated apartments, that is, by emanations proceeding from persons, who, though they may not be in perfect health, do not yet give evidence of the existence of actual fever. The effect of the cold affusion, as mentioned before, is here effectual, ? more effectual than in the others:?preparation of subject is moreover rarely required to precede its application. The duration is long, where febrile emanation from the living body is the cause solely, or in conjunction ?with impure air. It is perhaps still longer, where the disease arises from the contact of impure matter alone. This is supposed to be the case with those who touch infected clothing, or who com? within the sphere of condensed fomes ; for persons so exposed ar? ordinarily observed to experience a tedious disease, and one that is comparatively little tractable to the effect of usual remedies." The subject is further pursued under a more minute examination of the various forms of infectious fever; after which the author directs our attention to endemic fevers, or fevers arising ?from soil. These are divided into ihe mild and more simple? the more violent and complicated?the tremulous or irritated ?
&ndT Dr. Jackson, on Cold Jffusion in Fever'. 167 and, lastly, the stagnated or gangrenous form. The periods are next attended to, and divided into three, as the m'ost marked.' The next subject considered is those fevers usually called epidemic. These are divided into intermittent, remittent, low autumnal, bilious fevers, dysenteric, fevers with local affections, imflamm atory and eruptive fevers. On all, excepting the last,'Dr. S. is as minute as usual.
On eruptive fevers, such as small-pox and the othdr exanthemata, lie professes to have seen little, but that little is'fe" vorablc tovcold affusion; though no expectation is'ihdulged that in these fevers the disease can be cut short, as was often accomplished in the former.
In the measles the author never conceived'himstelf authorized to make the experiment. A recapitulation fcllowk of the. leading circumstances in which Dr. Jackson tliffers from Dr. Currie, the greater part of which will be unnecessary to those whb peruse the previous passages in the. work itself with the accuracy they deserve; and to others, we fear, it will answer but little purpose tohave dwelt so long on the controversy.

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The history of cold affusion is next traced from Hippocrates to the present day ; and the principles on which it is Used by the author are again adyertpd to. In detailing thp rules and reasons for the application of cold water to the surface, many ingenious arguments are adduced, to show that, besides the abstraction of heat, there appears something in the external application of water peculiarlyfavorable tp animal and vegetable life. This is' illustrated in a.
variety of pointed instances, many of which are constantly occurring in the conpnon transactions of life and of militVrPdiityj Having thus gone through the principal objects of controversy, and explained most minutely the plan of operation in the affusion of cold water in fevers, Dr. Jackson directs our attention to the effects of cold drink, and <Vf immersion in cold water, under various circumstances of disease, or of artificially excited heat. The effects of the custom are, as in the former instance, traced through the writings of the ancient and modern authors, as well medical us historical, till we arrive at the following account of the author's experience in himself, '

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In the year 1779, at Savannah, in the province of Georgia, in North America, in the excessively'hot weather of the month of July, I was attacked with the fever which then prevailed at that placc,?a disease which in the cooler season is intermittent, but which, in the hotter months of the year, has rarely either cold stage or distinct intermission. .In the third exacerbation of the case alluded to, my desire for cold water was ravenous in short?it appeared as if the. whole force of the febrile cause was exerted in the production of inordinate thirst, for there was'not at'the tirrie any other symptoms which attracted my notice. In'this state of torment from raging thirst, I desired to drink cold Water; and, notwithstanding'the unwillingness of those who were about me to yomply with my request, a jug was filled from the pump,? to the M 3 ' tea % l6s Dr. Jackson, on Cold AJfusion in Fever. best of my recollection nearly a quart. This I drank at on? draught; but the thirst still continued. The draught was repeated in a few minutes?but not to the same extent: the thirst was then completely extinguished, and I could not after that well say what other part of fever remained. Twent to bed about the usual time, for it was then evening, and passed the night in a pleasing reverie, or slight delirium. Next morning, when the impression of light Was sufficiently strong to fix my wandering ideas, I began to examine my situation ; and, among other things, found the epigastric region to'be much distended, but without pain, the eye slightly yellow ; while, together with this, I felt unusually languid and feeble; though I perceived no remains of fever; and even these symptoms vanished in a few days, qui?ckened in their rqtreat, perhaps, by some doses of calomel and rhubarb. Such is the fact; I notice it ?.s an instance of extinguishing fever by copious draughts of cold water; but I do not notice it as an example for the imitation of the practitioner.?The experiment was made at random ; and, that no evil followed from it, was probably more owing to the original soundness of my constitution than to my caution. I do not know the precise temperature of the water employed upon this occasion ; but, as it was pump-water, and drank at the instant it was drawn from the pump, it may be supposed to have been somewhere about 57?: the quantity I conclude to have been near three pints.? Such was the practice, and such were the effects in my own case. It is worthy of remark that, though the fever was extinguished ill the manner stated, neither vomiting, sweating, nor any other sensible evacuation ensued,?effects which are said by writers to be the usual concomitants of water drunk in the circumstances described, and in the quantity ht-re implied. There is here some difference in point of fact, the reason of which probably is that the ancients, and those who imitate them, generally administered the cold drink only in the advanced stage of fever, frequently near a critical period, oral the height of the paroxysm?a time, at which it is not possible to ascertain what part of the effect belongs directly to the genuine operation of the remedy, what contingently to the prepared condition of the subject. The cold water was here drunk at an early period of the paroxysm: it decidedly arrested its course or changed its condition ; but I cannot, in looking back upon the case, pretend to say that it did not bring life into danger.
The urgency of the thirst was unusual, and the means employed to extinguish it were carried to an unusual extent. They touched the extremes, consequently the example is not a safe one for imitation. I shall, therefore, mention, from experience in my own person also, an instance of the free use of cold water in another shape,?in such a one indeed as may be supposed to come more with-<fn,the rule of common practice than that related above. In the year 1778, in the month of October, I was attacked at Kingsbridge, on New-York Island, with an intermitting fever of complicated form, -attended, moreover, with some untoward symptoms through the v ' '? who] 8-> <r Dr. Jackson, 01% Cold Affusion in Fever, "169 whole of its course. I took an emetic at the first accession,, apd afterwards a strong dose of jalap and calomel; but the type, notwithstanding the effective evacutions thereby procured, still continued uncertain and anomalous, affording no fair opportunity for the exhibition of bark. I had an utter abhorrence of every sort pf food or sustenance except cold water. This I drank without measure, probably not less in quantity than two gallons per day. The water was excellent; and, as brought directly from a spring in a rock close to my tent, it was cool and refreshing. The pitcher stood by me:?I drank whenever I had a desire to drink, withoyt limiting myself in quantity, and I subsisted on water alone till the seventh day, when the fever terminated of its own accord. I still recollect the grateful refreshment which it gave me; and I may add, that though the fever was not extinguished by it, nor any of its paroxysms suppressed in the manner stated above, yet, the exacerbations were evidently mitigated, and I experienced comfort and even pleasure from it, not obtainable by any other means within my command at the time/' After this account of the safety and success with which the drinking of cold water was attended in himself, Dr. Jackson thinks it right to subjoin a number of cautions; so many, indeed, as may be sufficient to deter most young practitioners from the exhibition of the remedy on any terms, ; The subject of cold immersion is introduced by an account pf its effects on our author himself. Thesp were such as wp haye seen in some other highly sensitive subjects, a.high excitement pf all the animal functions bordering on fever. The case of Alexanderthe Great, as stated by Dr. Currie, is shown to be error neous^n the main point. Dr. Currie supposes him to have been cooled as well as debilitated; but it appears, on the evidence of Q. Curtius and Arrian, that he was extremely hot when he inw mersed into the river Cydnus, and suffered all those inconveniencies from his rashness, which common opinion would have taught him to expect. In this instance, we should say, Dr. Currie's eager pursuit of his favorite theory, has hurried him into an unaccountable error, did we not so frequently see similar instances in many otherwise correct writers. Some useful remarks are subjoined by Dr. Jackson, but as they rather arise from reasoning than observation, we shall omit thefrx to take notice of a practice of which lie may be said to be the author; tjiis is, the effect of gestation in the open air in wheel carriages or other conveyances, employed as a cure for certain conditions of fever. This remedy, like many others, was suggest^ by chance, and in two instances on the author's own person, before he was sufficiently aware of the advantage which might be derived from it. " In the following year,says he, I was again attacked at Ebenezer in the province of Georgia, North America, in the month of July, with, fever of unusual violence. The disease was pf the form which m 4 I TO Dr. Jackson, on Cold Affusion in Fever f'the ancient Greek physicians denominate causus. If had scarcely any remission, though it was fundamentally of the remitting type: the anxieties at the prascordia were inexpressible; the distress scarcely supportable ; the sensation of internal heat was great; the external heat little^ if in any degree increased ; the abdomen was cojafised and lank; the puliation of the descending aorta strong "and vibrating; the pulsation at the wrist moderatein force, perhaps \Veak, and not iriuch m'ore frequent than natural; the tongue was -'?parched and stiff; and'together with this, there was an abhorrence of drink, which appeared nauseous and loathsome. The sensations Were uncomfortable, the sense of burning was tormenting; yet the ' surface was frequently damp, ai-v!, as judged by the touch, not hot. The desire for something moist and cool was urgent; but nothing cool was to be met with,, the thermometer rarely sinking ? under ?>(5? at any time of the day in the best shaded part of the house"where I lay.
\jl ^-accommodated, exposed to night dews, scorching suns, and occasional showers, the majority were recovered or recovering by the end of the 3d day. As little or no attention could be paid to medicine during such a march, the improved health can be only imputed to the modp of gfstation. A great proportion of the sick recovered whilst waiting a.t the first halt to take a defensiye posture; others, in whom the disease had not entirely ceased, might be said to be convalescent, the form having changed froiu obscure remittent to that of distinct ague and fever.
The same advantages were found in the campaign in Holland, in the years 1794? and 1795, whenever it was necessary to shift the regimental hospitals and convey the sick in open carriages. In the Cove of Cork also, and in St. Domingo, the same advantages wkre experienced. This remedy, however, though so highly and generally valuable, is. not recommended as universal. The author gives several rules for'conducting it; the principal of which is, that it should be resorted to in the latter stages of fever, after natural or artificial evacuations, and where the strength s?ems greatly impaired. Thus have we gone through this valuable work, which, though it contains mnch more useful matter than most that come before us in a much larger form ; yet we arc obliged to confess, might stil^ be shortened. As this is the only objection we have to make, it is hardly necessary to add how much we recommend it to the perusal of our readers, not doubting that, like us, they will forgive this only error of the author, if they agree with us in thinking it such. of disease. The pain abates, and the swelling subsides considerably, when the scrotum has given way. In this state, the disorder appears very indolent; but, if the fungus be destroyed by any means, the integuments come together, and t cicatrix ensues, which is inseparably connected to the testicle. / ture of its attachment permit, by ligature ; or it may be freely treated with^ escharotic applications. The removal of the pijptuberance to a level with the scrotum, by means of the knife, is the shortest and mosjt effectual mode of treatment. I can see no ground whatever for proposing castration in this malady, since in no part of its progress, nor in auy of its possible consequences or effects, can it expose the patient to the slightest risk. Some may be disposed to defend the removal of the p5rt, because it would bring the case to a more speedy termination ; and if a patient, after being informed of all the circumstances, should desire the operation ou this ground, the surgeon would be justified in performing it. But I think he never could be warranted in proposing so painful and dangerous a remedy as castration for a, disorder attended with neither pain nor danger, and admitting of cure by a perfectly sp.fe and mild kind of treatment," After this, some of his readers will be surprized that he should mention, without reserve, the name of the Gentleman who actually performed the operation under the circumstances described by himself. This is, however, a mere inadvertence ; but, we are much inclined to differ from the general conclusion drawn by Mr. Lawrence in the last transcribed paragraph. When a part is so far restored, and this new situation is become chronic, it rarely happens that any spontaneous effort is made towards cicatrization. The fungus will sometimes ^kin over, but unless, a new action is excited, or unless the fungus is kept down till the scrotum can cicatrize, the disease, if it can be called such,, we have reason to believe will remain. On this occasion, may it not be reasonable to ask, whether, what is called hernia ot the brain, does not arise from a similar cause, that is, from the different offices and textures of the parts co cerned ? And if so, does not this explain how the disease is cured by retaining the scalp, and, if possible, inducing an union of ils divided edges.
We are by no means disposed to urge, that the cause we have assigned is invariable, but we have many reasons for suspecting that suppuration has always preceded this formation of fungus, or growth of granulation as we would call it. Even in the case in which Mr. Lawrence's friend performed th6 opeiation, there is great reason to believe, that slight suppuration, attended as it always is, Vfhere the curative process is regular, by surrounding adhesive inflammation, may have taken place in the substance of, or immediately under the tunica albuginea. However, vve are not disposed to lessen the merit of Mr. Lawrence s communication. The appearance of the part, under these circumstances, will be always formidable to young practitioners, particu'arly so, if he sees it before the general intumescence and pain have entirely ceased. The description was therefore much wanted, and it is here given in an intelligible and satisfactory manner.
The Edinburgh Journal, Article 9. ?Report of the General Hospital near Nottingham* By James Clarke, M. D. one of the Physicians to the Charity. I /This is the third paper from the same quarter. It contains U&* ful practical remarks, but most readers will think them too much detailed.
This article contains an useful practical remark on the delicate operation of extracting the Cataract. It is the author's opinion* that those unsuccessful operations, which are followed \yith considerable discharge of water and with pain, which last subsides altogether, are not the effect of matter formed, but of high-inflammation terminating in gangrene of the cornea. The cause of the gangrene he conceives to be, that the section is larger than necessary for the esc/ipe of the cataract.
Hence, thecirculation in the cornea, scantily supplied with vessels in order to preserve Hs transparency, is so much impeded, that no adhesion .of the cut surface can be procured, and the part dies in consequence. This is extremely rational; we see no objection to the opinion, excepting the pain which attends the process, and this may be accounted for by inflammation in the globe and eye-lid?.
The translation of this paper, though we doubt not very correct, yet is not without Gallicisms, which render it obscure i.U some parts. The Latin quotations are also incorrectly printed, att inconvenience extremely difficult to prevent.
Article 4. ? Observations on the Nature of Inflammation; and its Connexion with Fever ; communicated in a Letter to Dr. Andrew Duncan, junior. By Dr. A. Philits Wilson. .This paper contains several experiments on living animal,s, to show, that in inflammation the action of the capillary vessels is lessened, whilst the action of the larger blowd vessels is increased; but we shall endeavour to do justice to Dr. Wiisorv by following Jiim seriatim. He first remarks, that mere obstruction of the minuter vessels is insufficient to produce increased action in the larger, because the obstructed blood, is easily carried off by the .anastomosing branches, or the vessels may resist the distending force. The Doctor passed a hot wire through the web of a frog's .foot. Th's course, produced a shrivelling round the part. No ^uid escaped ; the biood was therefore obstructed, but no sign of inflammation Followed.
Respecting the general opinion that the circulation is more r?rpid. in an inflamed part, it is first shown by experiment on a living frog, that in proportion as the action of the vessels increased, the part became paler, which is accounted for by their greater Constriction. Here, therefore, was increased action without the true marks of inflammation, Jn another-instance in which in-'

X flammatieii
The Edinburgh Journal.

175
O f fiammation actually existed, the vessels were larger and fuller, but the motion of the blood was more languid, and in some parts where the inflammation was greatest, the circulation had ceased altogether. The smaller vessels, which in a healthy state are impervious to the red particles of the blood, were injected. u Whilst," says Dr. Wilson, " I was viewing the inflamed web, it occurred, that it I could succeed in stimulating its.vessels to' action, and thus remove the inflammation, it would afford an ad-' aitional proof of the inflammation depending on the debility of the vessels. v . " " With this view I wetted the inflamed web with distilled spirits, <lt the same time throwing upon it the concentrated rays of the sun from the speculum of the microscope. The blood in all the vessels, except in those of the most inflamed part, began to move with greater velocity, and in proportion as this took place, the diameters of the vessels were diminished, the redness became evidently less remarkable, and the interstices of the vessels less fepaque.

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After 1 had despaired of restoring action to the most inflamed part, I saw the blood begin to move slowly in a vessel wliirife ran directly through the middle of it. It soon acquired a considerable velocity and, on taking a superficial view of the part throdgh the microscope, the course of this vessel appeared like a streak of a lighter colour through the middle of the inflamed part.
" As I had not observed the inflammation from the commencement in this experiment, I repeated it with the assistance of the Keverend Mr. Boraston, on a small fish (the lampern.) " We found that exposure to the air pro luces a degree of inflammation, evident to the naked eye, in the fins and tail of this fish. On viewing the former through the microscope, we observed the circulation become more languid, and the. vessels enlarge as the inflammation came on. The motion of the blood ii>. the most inflamed vessels itt length ceased altogether. " By gentle friction, and applying distilled spirits, we repeatedly succeeded in accelerating, and even renewing the motion of the blood ; and, in proportion to the velocity of the circulation, the vessels became evidently paler, the deeper red returning a3 the circulation became more languid." This experiment was repeated on the fm of a fish with'nearly the same result.
To see how far the same would happen, in what are called warm blooded animals, a protruded part of the mesentery of a rabbit was brought within the field of a microscope, and irritated by the point of the forceps; the observation being made by a Gentleman unacquainted with the theory, whilst the Doctor conducted the experiment. ,

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The larger arteries and veins were too opaque to admit of n?y distinguishing the motion of the bl?od ; 'but in the small vessels, The "Edinburgh Journal.
vessels, which were more transparent, the circulation was easily observable; and I perceived the globules of the blood moving along with great rapidity, but not in sufficient quantity to give a. red colour to the vessels. c " After a few minutes exposure to the air, the vessels became visibly enlarged, and in some parts assumed a reddish colour, while the velocity of the blood was proportionably diminished.
"As soon as a part of the mesentery, which, lay within the field of observation, and appeared almost colourless, was irritated with a point of a small pair of forceps, a red sp(,t appeared-In a few seconds it increased in size, the adjacent parts of the vessels weie distended, and the current of blood becoming less rapid, was for some distance slightly tinged with a red colour. This enlargement of the vessels gradually extended ; the circulation at this time was extremely languid, and at length was not discoverable at all." Such then, continues the author, appears to be the state of a part under inflammation ; the capillary vessels distended and debilitated ; the larger arteries excited to increased action.
The increased heat with which inflamed parts are attended# must, it is added, arise from the blood parting with m rp caloric; but as part of this blood remains without again making its passage through the lungs, it is less in a condition to evolve caloric, than the blood of a healthy part. Mr. Hunter found by experiment, that the increased heat of inflamed parts is not more than 1 in <57 cr ys ; and, as by our author's experiments, tho increased quantity of blood il considerably more than doubled, it follows, that less than half the above quantity of hc-at is evolved in / a given space under inflammation from the same quantity of blood.
The increased pulsation of the larger arteries is imputed, as may be expected, to the vis a tcrgo endeavouring to expel the forward, the tardy, or stagnant blood through the capillaries. If this vis a tcrgo is insufficient, the consequence is, that the circulation ceases altogether and mortification follows.
The vis a tcrgo, we are told, is not only increased by the obstruction to. be overcome, but the secretions of the inflamed part beiijg interrupted, that portion of blood which would have been used for these secretions remains, and adds further to the stimulus ob the vessels, which is gradually increased and extended backward to the heart itself.
Such are the outlines of Dr. Wilson's theory of inflammation, which, if rightly understood, will readily illustrate his theory of fever " On reviewing," says he, <c the phenomena of fever, we shall find them altogether analogous to those of inflammation, and that the, experiments which have been related can be applied with the , same success to explain them. The symptoms which constitute inflammation are increased heat, redness and swelling, whetherattended The. Edinlitrgh Journal. 37t attended by pain or not. In the commencement of the hot stage of fever, particularly in strong habits, the whole surface is affected with increased heat, redness, and swelling. Here, then, we know from direct experiment, that the capillaries are debilitated. The more active symptoms of inflammation do not shew themselves, because the whole capillaries being debilitated, the distending bears a small proportion to the resisting force ; whereas, in inflammation, the debility of the capillaries b^ing very partial, the resisting bears a small proportion to the distending force.
The Etlinbtirgh Journal'* and thus it is, that the debility of the capillaries, "and along witfe it, the fever, is often renewed for some time after it has ceased, by too full'a diet, 'exercise* or any other caiisc that increases too much the force of the heart and larger vessels, and thus throws on the capillaries a larger quantity of the fluids than on the first return of their vigour they can easily bear. A full meal, under these circumstances, is often succeeded by a strong pulse and & tlrjr skin." By the analysis we have made, and the extracts transcribed, it will not be difficult to see the object of Dr. Wilson, which we were formerly obliged to confess was beyond our reach. It is not necessary that we should offer any opinion of our own? because, we are informed, that in an edition of his Treatise on Febrile Diseases, which he is now preparing for. the press, the subject will t>e entered into more at large. Whenever that edition appears, ?we shall have the whole of the question before us, and then will be the time to discuss it with that candour we always wish to shevy every author.
Article 5.?An Instance of Condensed Lungs, related with a Via* of enquiring whether or not this Morbid State ought to be considered as of a different Kind from Inflammation or other Diseases ah ready distinguished. The subject of this case was a lady in the sixth month of her pregnancy, seized with pains in her chest, dry cough, short breathing and a shivering fit. The pain increased with the other symptoms till morning; the patient was bled ; the same was repeated in the evening ; the pulse small and quick, but the heart making ?violent efforts to contract. On the 4th day the bleeding \Vas re-^ peated. On the 5th, a violent pain in the head absorbed all other sensations ; this induced a free application of leeches for immediate relief; with what success we are not informed, but that the patient seemed in a dying condition ; and as a temporary relief, cupping with the scarifyer was directed for the chest. She miscarried, and died.
The following is the account of the dissection, with the author's remarks. " Dissection.?On Thursday, April 14th, on opening the tho* rax, the lungs appeared not at all collapsed, but were firm like liver or spleen j the right lung was more consolidated than the left, A little semi-transparent, seemingly coagulated lymph, was found adhering to the pleura of the right side; and about eight ounces of water were taken out of the cavities of the chest, especially from the right side. The lungs being cut through in various parts and directions, the air vessels seemed obliterated, so that a very small part only of them floated on water. The right lung throughout was so dense as to sink in water.
The colour in the interior was like the surface. There were no tubercles, nor vomicae, nor thick* ened membranes, nor swelled glands; but the most remarkable appearance was the effusion of a turbid fluid into the trachea, so i* The Edinburgh Journal.
.l/iJ fco fill it, and which, no doubt, occasioned suffocation. This turbid fluid consisted of seruin, water, slime, or mucus, and some coagulated masses of lymph.
There was nothing unusual about the heart, arid the foranieri ovale was not, (as ih niany cases of diseased lungs) opened. Iti other parts of the body nothing morbid was seen.
. " Remarks.?From the propensity to generalize, I know that the above described disease and dissection would be referred to inflammation. But on consideration of the phenomena, the characters of inflammation will be found to have been absent. It is trtie, that effusion of watery fluids, and of coagulated lymph, and condensation, are effects frequently of inflammation; but then these effects are attended by decisive and peculiar signs of inflammation, viz, redness, thickening or enlargement, adhesions, pus, and, previously to death, by symptoms of general, or at least local inflammatory action, tn the preceding case, we have neither the symptoms of pleurisy, nor of periprieumohy, nor of pneumonia. The pain of the side wits Supposed more like a spasmodic, than an inflammatory one.
Effusion of water, and secretion of slime, are not the effects peculiarly of inflammation, but of various kinds of irritation and obstruction to the circulating fluids. It Seems against experience and analogy, that for three or four days* inflammation of every part of both lungs should exist, without the symptoms of that disease, and yet sufficient to occasion an universally condensed state of them.
Obstruction to the passage of the blood accotlrits for the effused fluid into the trachea, and into the Cavities of the thorax ; but what occasioned the consolidated state of the lungs ? The consolidated State appears to have befcn the original disease, not the effect of some other disease; and its otcilrrence to so great an extent in three or four days, has not, I believe, befen seen before?
The absence of ortUopnoea, of bufty bloody of hard pulse, of white tongue, of expectoration* and but little of cough, or any other particular* distinguish the present disorder from other well known thoracic affections. The rapidity of its progress will tiot escape attentiom The dyspnoea was A peculiar one. The violent attack of peculiar excruciating pains of the head is also remarkable. The state of pregnancy is, perhaps, to be regarded merely as a casual coincidence, and not as peculiarly connected with the disease. Death immediately by secretion into the trachea, I belifeVe,, has frequently been overlooked; it often b'ccurs in infants, and account* for unexpected deaths." As no name is appended to this communication, we shall not be accused of want of candour in offering a few remarks on it. The author conceives the disease no way connected with pregnancy;.
Had nothing appeared but the effusion into the tra'chea, we might ha\e been of the same tipinioh; but it is certain, that during preghancy, a very extraordinary quantity of blood is often made ; Pitiless those prodigious haimorrhages which at another time no woman, couid support; witness the relief which bleeding affords under most ( No, 114. ) jsj complain^5 complaints during pregnancy; witness the great loss of food by perpetual vomiting, under which females suffer much less than at any other period. This increased quantity of blood seemed determined to the lungs, and at one time, to the head, (whether the latter was examined we are not informed.) In this unnatural state of the lungs, the cells must either burst, and the blood be effused into the air cells, or adhesive inflammation must take place to suppqrt the parts. Considering the texture of the lungs, it is obvious that if the disease continued, the adhesion must continue, till by degrees the office of the lungs would be destroyed. If, in the mean while, lymph should be extravasated into the distant branches of the bronchia:, it would find its way to the trachea, but could not bq coughed up from the condition of the lungs. All this we offer as conjecture, and should a similar case occur, if we may jud^e by what we have witnessed ourselves, the first bleedings, and the repetition of th:-m, should not be measured by ounces, but by the relief experienced, and the indication of the returning symptoms. Article 6.?Instance of an Endemie Cynanche Parotidea, on board his Majesty's S/iip Ardent, on her Passage to Monte Video. By Andrew Noble, Surgeon of the Ardent. case with which Dr. Cheyne introduces his observations, is very well worth recording; but the greater part of his subsequent remarks might "have been omitted. As we have no reason to suppose that any -of our readers at present are ignorant of the propriety of attending to alvine discharges in all chronic diseases, we shall de-r clirie any further notice o( this part of the paper. By some quo* tations produced, it would appear tis if some judicious, and even celebrated practitioners, were not sufficiently aware of the impropriety of strong stimulating purges in cases of inflamed bowels, i'he author's observations, in this respect, may be useful, but he is r>ot sufficiently minute in describing the symptoms of inflammation.
Where the pulse is small, the pain violent, the tension and tenderness considerable, the free use of the lancet, and, perhaps, of topical bleeding, is absolutely nccessary : nor can we expect any advantage from purges, however strong, before we  Nothing can give us greater satisfaction, than a controversy carried on like the present. We have already shown our high opinion ?f Mr. Ellis's labours, by the early notice we.took of it in our critical analysis ; we have not been .less attentive to Dr. Bostock's reply. Each is replete with good sense and good manners, and we hope the correspondence will bekept up with the same zeal and temper on both sides. We shall for the present, look on as impartial spectators, till something new appears, or till we perceive something new to offer our readers.
The Inquirer occupies his corner; and it is not a little curious to *ee Dr. tferriar accu.-ed of the same plagiarism as he has effectu-al}' fastened on Sterne. It appears that Lorry, in the year 1784, Published a Tract on the conversion of diseases. Somt passages are brought, to show the similarity of the two. The author does not, s<ietn" quite aware to how much advantage Dr. Ferriar appears iti the comparison. It is, indeed, afterwards said, that " in treating of a Complicated series of morbid actions, there is great danger of bebewildered in the maze of chimerical notions, and this the more Specially if the author sets up for a system-maker. Something of ll>is kind, we apprehend, has happened to those who have examined 'he conversion of diseases before Dr. ferriar. He h >s pointed out the true method of inquiry, he has added a good example to a judic'ous precept, and endeavoured to vecal physicians to t at line of study by which Hippocrates and Sydenham enjoy a sort of immortality upon earth, and at this day read leetuWs to all the world." Thus, after a spice of abuse, Now, we should be glad to know in what passage Mr. Huntcr eyer says that two similar morbid actions at the same are iucompati" ble< We have frequently heartl his disciples assert, that two local d|s" eased actions cannot be carried on in the same place, nor two d,s" eased actions in the same constitution. But the similarity of the actions would supersede the whole theory, which only rests on fie difference : and it now appears, that small-pox and cow-pox, th? both constitutional, can go on at the same time, on account of th^ similarity. But it is hardly conceivable, bow the writer should have overlooked the difference between the two writers. J. Hunt?1" speaks of diseased actions, one of which will be suspended, white' the other is proceeding. Lorry speaks of actions tending to health' one of which, he says, will lie torpid, or altogether excluded b) the other. This is a matter of very little consequence, as Mr* Hunter delivered his opinion before Lorry, but it is as just that Lort-y should be excuscd from an unjust char'ge of plagiarism aS Hunter ?r Dr. Ferriar.
Essays on the Morbid Anatomy of the Human Eye. By JAM?* Wakdrop, Fellow of the Royal College of Surgeons, of the Koyal Medical and Chihirgical Societies, and one of the Suf/ geons of the Public Dispensary of Edinburgh. Illustrated n'i^ Plates; la:ge 8vo. Edinburgh, 1808. I?r a Preface, the Author observes, that a work professedly 011 the Morbid Anatomy of the Eye, is hitherto a desideratum: Continental writers* who have principally engaged the public , tention, hiving done but little towards illustrating their remarks bf engravlhgs. He acknowledges the information he has derived ff?^ these writers, and from the practitioners of his acquaintance, a11 Concludes by informing us, that should the piesbnt specimen ^ well received, it is his intention to prosecute his plart, by con' iidering the remaining diseases of the eye and its appfendages, u'' the treatment which such diseases require. Some preliminary observations follow; that all animals composed of organs, which, under the influence of the vital cipic, produce those wonderful phenomena that distinguish organized bodies ; that a knowledge, of organs, is one of the iects ot anatomy ; that on it the surgeon builds all his thcor'cS 1 aP* and that it guides his hand in every operation. This, however, is only to be considered the first' step. " WbctV says our author, " the anatomist divided the body into regions and districts, and shaped his inquiries to suit his uunatural divisions, every organ appeared insulated and detached^ the most minute parts might ha.yu besn dispovered and described, but their mutual connections and sympathies were unknown. Anatomy and physiology were then disjoined; the former was im* perfect, and tl)c latter could scarcely be said to exist. " A more minute and philosophical examination of the structure and properties pf the different organs, lqd the way to a knowledge of some of their functions, and pointed out the principles which should regulate the investigations of every rational physiologist. Haller was among the first to ayail himself of the advantages of this plan-It conducted him to all his important discoveries; and it has determined th,e progress of every scientific inquirer since his time. Tcj it we are indebted for almost every improvement that has been made in this bf^nph of science.; and it is the only method by which \ye can hope still further to augment our knowledge. In pursuing this track, the labours t;f modern anatomists have been \yqll rewarded. They hayp freed physiology and pathology from the nonsensical conjectures by which they were so long debased, 50 that they now begin to assume their rank among the sciences, and some cases to'afforfl a a safe guide to the medical practitioner." That Haller did much towards correcting many anatpmical errors and completing some researches cannot be doubted; it k;, however^ still doubtful y/hether, he has done much towards improving Physiology .-?But vvp shall continue to transcribe. " No one in our day has exerted himself more successfully in this field than the late celebrated Bich&t. His Anatomic Generate is one of the most remarkable productions that has ever been produced in paedical science. It has unfolded a path of investigation which was scarcely ever trodden before, and laid the foundation of a new anatomy apd a new physiology. I cannot pretend herp to do justice to the merits of this work, nor to give a correct view of the facts and reasonings by which his doctrines are supported. They are as numerous and various as are the parts and functions of the living body, Elut, as I propose, in examining the pathological anatomy of the eye, to adopt some of the principles ?which he has established, thq following observations are necessary, in order to explain the purport and tendency of the classification which I mean to adopt. Most of the organs of our body are made up of s, variety of * elementary parts, or textures, each of which, in whatever situation it is found, affords uniformly the same physical properties, lhese are the elementary parts, which, by the diversity of their .combinations,, produce all the modifications of structure an I functions which the different organs of animals exhibit. The study of 2S 3 ^iese / * Mr Wardrop's Essays on the Human Eije. ' these elementary parts, independent of the organs which they concur to form, is the object of general anatomy. u This method of considering organized bo :ies, is not an unnatural abstraction, nor a speculative refinement. It arises from, the essential nature of their constitution, and it accords with every phenomenon with which we are acquainted. We may trace it in the observations of many of the older anatomists; and it may be 'considered as the basis of some of the rnost ingenious physiological theories of the late celebrated Mr. Hunter.
Although, therefore, at first sight, it may have the appearance of being arbitrary and artificial, it is nevertheless, I am persuaded, founded on the most approved principles of philosophical investigation. A knowledge of the qualities of the different parts of which our organs are composed, must afford the surest means of acquiring information concerning the functions of these organs, and of becoming acquainted with the changes which they undergo in disease. On these principles Bich&t has founded his anatomical system. To numbedess experiments upon living animals, he has added ail the information which could be acquired by dissection. He employed chemical re-agents to supply the deficiences of the scalpel, and examined with minuteness all the varieties of morbid structure. By these means he endeavoured to fix the characters of the elementary textures, and then proceeded to investigate their combinations, as ihey are naturally presented to us in the different organs. " Of these textures, he has enumerated twenty-one, all of which he has shewnrto be differently organized ; and hence he proves the dissimilarity of their properties, both in health'and in disease. This'is the ground-work of the whole fabric, and to it we must'ultimateley recur in every attempt, to account either for the natural or morbid appearances which are to be met with among organized beings." " p mean not," continues Mr. Wardrop, " to enter more minutely on the consideration of elementary textures/' We should be extremely glad to learn what elementary textures mean, or why they are to be entered upon at all, if not to introduce some practical remarks.
If the meaning was to shew that parts differently "organized exhibit different phenomena when under inflammation, it ' AVould have been sufficient to trace some of those laws which Mr.
Hunter has pointed out, in explaining the various forms of inflammation. We are indeed slightly referred to him and to Dr. Carmichael Smith's confused attempt at arranging the different species of inflammation; but'BiCHAT is the source of all our Author's speculations. Bichat has informed us, that mucous membranes, whether in the nose, the intestines, the vagina, the bladder, or in whatever part, are affected in a similar manner. It is much to be regretted, that Mr. Hunter's divisions of different kinds of inflammation, according to the nature of the parts affected, are not better known, that we might wpnder less at these astonishing discoveries of M, Bichat and other foreigners.
.After Mr. War drop's Essays on the Human Eye. 185 After all, it ma)' be doubted, whether, in a practical work, the inquiry is.as important as it is interesting and curious. " The principles which I have stated,'' continues our author, " account admirably well for the propagation of some affections, and for some of the sympathies which subsist between difterent parts of the body; but there are other disorders which advancc in a different manner. In some diseases which are termed chronic, for example, the whole structure of an organ becomes gradually altered, although the primary affection was confined to one of its component textures. This is often to be observed in cancer, scrofula, lues venerea, &c. When cancer attacks the mamma, it is, at its commencement, generally confined to a small portion of that organ, but if allowed to proceed, it ultimately involves the whole glandular, cellular, and cutaneous textures, in one common mass of disease.1" It is far from our wish to undervalue the labours of those inquirers, who trace Nature in all her operations of disease, as well as health. But, we wish much, that every work should be simplex ct unum. Mr. Wardrop cannot expect that these hints, for they arc nothing more, can assist his readers in prosecuting such delicate enquiries, nor does the nature of his woj'k require it. In a practical view, it is sufficient that he points out the symptoms of inflammation in the eye in its early stage. I it. the the progress, if